Varicocele Leading Cause of Male Infertility, Expert Explains

A specialist in andrology at Cipto Mangunkusumo National Hospital (RSCM), Prof. Silvia Werdhy Lestari, stated that varicocele is the leading cause of male infertility. Varicocele involves the swelling and widening of veins within the scrotum or testicular sac.

‘Some cases may involve post-testicular issues, such as transport problems due to varicocele. This is the primary male factor in infertility, but having varicocele doesn’t automatically mean poor sperm quality,’ Prof. Silvia said at RSCM’s Yasmin Clinic in Jakarta.

Medically, the main cause is faulty one-way valves in veins, leading to blood backflow, pooling in the scrotum, swelling, and increased testicular temperature. Beyond medical factors, Prof. Silvia highlighted several lifestyle habits that are often overlooked and can trigger or worsen the condition, among them: many men feel anxious when diagnosed with varicocele. However, surgery is not always necessary. Treatment depends on patient symptoms and sperm quality.

‘We prioritise sperm quality for fertility. If grade 3 varicocele is present but sperm count and DNA are good, intervention may not be needed. Each case must be assessed individually,’ she explained.

Given men contribute half the factors in fertility success, sperm quality checks are advised before marriage or IVF planning. ‘Infertility isn’t just about mothers; fathers play a role too. Solving male infertility addresses half the problem,’ Prof. Silvia concluded.